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HomeMy WebLinkAbout07-17-09PETITION FOR P~~JROBATE A'JND GRANT OF LETTERS REGISTER OF WILLS OFC.LL~9SP: ~l~nU COUi~1TY, PE~:tiS~'LVAM~ Estate of ~ !~/ File Number ~1 ~~`1 iw L~,`~ also known as iy7 H ,Deceased Social Security Number ~f~ _ l)~S' - GI;j jS% Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE A' or 'B' BELOW.•) ~° A Probate and Grant of Letters Testamentary and aver that Petitioner(s) is /are the C~ j~ ~ ~ %r~~ S named in the last Will of the Decedent dated/U~~%d~/y~i~~ and codicil(s) dated (State relevant circumstances, e.g., renunciation, death of executor, etc.) Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered for probate, was not the victim of a killing and was never adjudicated an incapacitated person: ^ B. Grant of Letters of Administrate (If applicable, enter: c. t. a.; d. b. n. c. t. a.; pendente life; durance absentia; durnnte minoritate) Petitioner(s) after- a proper search has /have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (If Administration, c. t. a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ~ N Name Relationshi ~ '~ ~~ Resi ~ -. m _ - - (COMPLETE I,Y ALL CASES:) Attach additional sheets if necessary. ~ -'' ~ ~ - ~_ ~ "~ N i Decedent was domiciled at death it County, Pennsylvania with his /her last princip~a7residence atQ~ L ~ f ~ s,- -...t (List street address, town/city, township, coung~, state, zip code) Decedent, then _ years of age, died on ~ -! l D/ at ~ (' (~ t' ~ ~ t~ ('~ ~L~ ~~ j ~~ Decedent at death owned property with estimated values as follows: (If domiciled in PA) All personal property (If not domiciled in PA) Personal property in Pennsylvania (If not domiciled in PA) Personal property in County Value of real estate in Pennsylvania ~~Cl- DDD,~J !~ ~c,. ,axis _. Form R6V-0? rev. 10.13.06 Page 1 f . i situated as follows: l~ ~ e~j (~GL.l~ t ~~~~~ ~ I ~ ~-/~ ~ -7 U ~ 5 Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to the undersigned: Oath of Personal Representative COVI;vIONWEALTH OF PENNSYLVANI_=~ SS COUNTY OF ~~1 ~ I'Cl~~ f ~~~ The Petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing Petition are t rue and correct to the best of the knowledge and belief of Petitioner(s) and that, as personal representative(s) of the Decedent, Petitione d will we ll ~ truly administer the estate according to law. n ~ i _~ ~ ,~~; ;---; { J ~ ~ 1 ~'~ ` -i Sworn to or affirmed and subscribed \ ~ i, ~' " m ~ ~ ~ ~ ~ Si ata e of ersonal epresentati e `~ ~'~ _ ~ - before me the ~_ day of ~=,=~ ~ ~' ,-- i ~~~ `= N ve Si nature ojPerso~ial Representat \ ~ t 't> _ j c v N . ~ _ For the ReglsteC Signature of Persm~al Representative File Number: oC 1 O C~ ~~(.~~~ Estate of ~~.~/Y~~- ~ ~ L~/i ~'~` l/~l~ > Dac.~ased ~ CAS L/J /;~~ ~~ ~3- ~ ~~ ~ Social Sec{~urity Number: ,{ ~i8 i r~ ~.r Date of Death: AND NOW, 0 r1 ~~ ~ i ~ J ~-'L l , ~c~'1C1~ , in consideration o the foregoing Petition, satisfactory proof having been presented before m , IT IS DECRELetters `~' T ~ %2~ are hereby granted to ~ . ~~ ~PYY l~ ~l~ «!' ~ ~ l,1 f~ _ /i ,,/ J in the above estate and that the instrument(s) dated ~~C U~r ~ ~ ~ ~"l"~~ described in the Petition be admitted to probate and filed of record ~s the last Will (and.~odicil(s)) ol~D,ecedent FEES Letters .......,.. . -. Short Certificate(s) ..Jf ... $ o~G Renunctatioy~(s) ....°.~ .... $ / ~ Geri 11 ... $ l ... $ 1D t. J ... $ ... $ ... $ ... $ TOTAL .. . ... $ ... $ ... $ ,~ Attorney Signature: Attorney Name: Supreme Court I.D. No.: Address: Telephone: Form RW-0_' rev. is r3.or Page 2 of 2 Register of Wills ~!'""~ 1~ ~" ,~° i~ /f,Jl j IUS_RU5 HEM %U110' i LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, ~i6.00 Y~~~~ ~~~~ ~,; Certification Number This is o(3 certify that the intorT~~atiim here given correctly cclpieLt. lrnm an origina(I Certificate of Deg duly filed tivi?h me as LtTad Rer~i~trar The orit~i certificate ~~~ili be ii>rwardcd to the State Vi Records Ofti,~e for permanent filint. Local Re~ri~t~ar llate Issued ~ ~ C' ~ c°a ti+a -, ) `~ ~ - I`F") ~~ ''i -; r -. C~.i -r7 "Y7 ~ .~ ~ ~ '~" ti ~~ N ~ • fEV tlnoos COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS PgINT IN ANENT CERTIFICATE OF DEATH ;K INK (See instructions and examples on reverse) ~ ` ~` ~!) l ~% ~ ~) STATE FILE NUMBER J 1. Name of Decetlenl (First, meddle, last, suffix) 2. Sex 3. Social Sacunly Number 4 e of ath (Month, tl y, yea 1'C ~ Thelma L. Wright Female 048 _ 05~~ 0518 , ~ ~ ~ 5. Age (Last 8irthtlay) Untler 1 year UrMer 1 tlay 6. Date of Birth (Month, day, year) 7. &nhplace (Clfy and state or for eign coumry) 8a. Place of Death (Check Dory one) / 8 8 Manors Days can Menmes 7/ 2 3/ 1 9 2 0 E n o l a P A Hospital: f Other vra. , or tr tient ^ ER / om rant ^ DOA ,ty pa pa ^ Nursing Home ^ gesidence ^Other ~ Speciy: Bb. County of Death 8c. City, Boro, Twp. of Death fig. Facility Name (If not institution, give street antl number) 9. Was Decedent of Hispanic Origin? ~] No ^ Yes 10. Race: American Indian, Black, White, etc. Dauphin Harrisburg Harrisburg Hospital (If yes, specity Cuban, Mexkan,PuertoRican,etc.) (Speciy) White 11. Decedem's Usual Occu Lion Kind of work d one d un most of worki INe. Do rat stale retiretl 12. Was Decedent ever in the 13. Decedent's Education (Spacity Doty highest grade compl eted) 14. Marital Status: Married, Never Mametl, 15. Surviving Spo use (If wife, give maiden name) Kind of Work Kind of Business I Indust ry U.S. Armed Forces? Elements / S Gonda 0-12 ry ry ( ) Colle ~ n 4 o ~') Widowed, Divorcetl (Speaf» Cafeteria Manager E. P. S.D. ^yes ~CjNo I I Widaaed 16. Decedent's Mailing Atldress (Street, city I town, state, zip cotle) Decetlent's PA Did Decedent y~z-, E85t PennSbOTO State Live in a 17 Actual Resitlence 17a V D L 47 Grant St . c. t• I es, ecedent ived in Twp Township? . Ctsnberland 17d. ^ No, Decedent Lived wNhin 17b. County Enola, PA 17025 Actual LimNs of Ciry Boro 18. Father's Name First, middle, last, sufix) 19 Mother's Name (First, midge, maitlen surname) Harry irTe :ode Beck '___ 20a. Infortrent's Name (Type / Pdnt) 20b. InformenYS Mailing Address (Street, city /town, state, zip cotle) Darrell L. Wright 157 East Columbia Rd. Eno1a, PA 17025 21a. Matted of Disposdion ^ Crematbn ^ Donaton 21 h. Date of Disposition (Month, day, year) 21 c. Place of Disposition (Name of cemetery, crematory or Omer place) 21d. Location (CM /town. slate. zip code) ® Burial ^ RemovaltromStale ~ WasCremationorDOnetlonAumonzed ^No ^ Other - Specity~ i by Medical Examiner I Coroner? ^Ves July 16, 2009 Enola Cemetery Enola, PA 17025 22a. Signature of Furreral rvke Licensee (or person aging as such) 22b. license Number 22c. Name and Address of Fecif - ;/°i,,.,N ~i J FD 012774-L Richardson rat Home Inc. 29 S. Enola Dr. Enola, PA 17025 Complete Items 23ac only when certifying physidan is rat available at tlme of death to 23a. To the I my knowledge m oaurted at the ti to and place (S a aaaa~~~ngldm4~ 23b. License Number L Date Signetl (Month, day, year( ~ /~ / ^ `„% am rtN d O j ~ / / , E ' " ` e / . cR y cause e ~ ~ ~ G. _ Items 24.26 must be completed by person 24. Time of Dea J 25. Pmrau ed Dead (Month, day, year) 26. Was Case Reterretl to Metlical Examiner / Coroner f a Reason' Cher Than Cremation or Donation? who prartwnces death. ~. M, V VV ^ Yes ~No CAUSE OF DEATH (See InstrueU and axe plea) t Approximate interval: Pan II: Enter other 5lgnific_nt conditions contnb mny to ath, 28. Ditl Tobacco Use Contribute to Death? Item 27. Part f. Enter the chain of events -diseases, injuries, a complicatrons -that dreclly causetl the death. DO enter terminal events such as caNiac ores!, t Onset to Death out not resulrnq in the underrying cause given In Pan I. ^Ves ^ Probably respiratory ones!, a venMCUlar fibd lotion without showing the etiology. Ust Dory one cause on each line. t ^ No ^ Unknown t ' IMMEDIATE CAUSE IPinal tlisease or /y ~~ /i' ~ / L) I r /,2'~ condition resulting In death) _~ a ~ ~ l tf ~ 29. II Female: (~ M1 ~ Due to r as oq: ' + v • Not pregnant within past year 1/ /~ > >`,~,~~ ! ` Sequentialty list condaions, if any, b / v~~° ^ Pregnant al time of deem leafing to the cause listetl online a. Due to or as a cons rice o Enter the UNDERLYING CAUSE ( e9ue 0~ ^ Not pregnam. but pregnant within 42 days edsease or injury mat inaiatetl me c vents resulting en tlealh) LAST. of death Due to (or as a consequence of): ^ Nol pregnam. but pregnant a3 tlays to 1 year d before death ^ Unknown it pregnant within the past year 30a. Was an Autopsy 30h. Were Autopsy Findings 31. Manner of Death 32a. Date of Injury (Month, day, year) 32b. Describe How Injury Occuned 32c. Place of Injury. Home, Farm. Street, Factory, Pedormed7 Available Prior to Completion ~ Natural ^ Homictide OKce Building, ale (Specify) of Cause of Deam? ^ Yes ~~' No ^Ves ^ No ^ Acndent ^ Pending Imestigetion 32d. Time of Inlury 32e. Inlury at Work? 32f. If Trareportation Injury (SpecityJ 32g. Location of Injury (Street, city /town, stelae ^ Suicide ^ Could Not be Determined ^ Yes ^ No ^ Driver I Operator ^ Passenger ^ Pedestrian ~ M ^Olher-Specify: 33a. Certifier (check Doty one) ing cause of death when another physiaan has pronounced death and completed ttem 23) • Certityin h sician (Ph sician cedif 33b. Signature and Title of Certifrer - ,~ .-; '" ~ ~ / ~ ~ / ~ " g p y y y To the best of my knowledge, death occurced due to the cause(s) antl manrcer as stated_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ` - l ~ ~ - -- f '~ - -- ' ' -~ ~ _ ~ • Pronouncing antl cert'rfying physician (Physician both prononcing death and ceNrying to cause of tleath) ^ 33c. License mbar 3 ate Signed (Month. tlay, yeah ' I / To the best of my knowledge, death attuned at the tlme, date, and plxe, antl due to tbe !oase(s) and manner as stated_ _ _ _ _ _ • Medical Examiner/Coroner + i // ~ ' / ~~~ On the basis of examination and / or investigation, in my opinion, death occurred at the time, tlafe, antl place, arM due to the cause(s) and manner as stated_ ^ ~ 34 dgwas~f arson 0p~pf~jd c/yse at1~ em Typgyy '' ~: 35. Registrar's ignature antl District Number 36. Dale Filed (Month. day, year) ~ _ '~ ,~'~ c- l ..~ tt7 .. ~.._ - _ - 'V ~ f)icnn<illnn Pcrtnif Nn ~~_ / ._ ~. .r ~ ~~~ ~ `'~- , LAST WILL AND TESTAMENT YNOW ALL MEN BY THESE PRESENTS THAT:I. THELMA L. WRIGHT, 47 GRANT STREET, ENOLA, PA., 1725, being of sound and disposing mind and memory, do make. publish and declare the following to be my last Will and Testament, hereby revoking all Wills by me at any time 'Heretofore maade. FIRs@:a I direct my Executor, hereinafter named. tp pay all my funeral expenses administration expenses of my estate, including Inheritances and succession taxes, State or federal, which may be occasioned by the passage of or succession to any interest in my estate under the terms of this instrument, and all my just debts, excepting mortgage notes secured by mortgages upon real estate. SECOND: All the rest, residue and remainder of my estate, both real and personal, of whatsoever kind or character, and wheresoever situated shall be divided Everything to my husband, Alvaro L. Wright. In the event of hisdemise, everything is to be sold and equally divided among our three children: Ms. Karin Wright Willey Salisbury Mobile Home Park ~~-. © o ,1 Box 256 ~ , ~-- ; Salisbury, Maryland, 21801 c7 --=`'`' L~ <~ r-n r- c~ ~ ~ .~7 ~ )C> .,, J _ i ~ .., ".~ y7 ~ Mr. Darrell L. Wright ~ _ Box 117J R. D. #1 ~--t N N Elliotsburg, Pa., 17024 ~ ' J i 11 Henry :' 818 N. High St. Duncannon, Pa., 17020 THIRD: I hereby appoint Jill, Henry, 819 N. High St. Duncannon, Pa., 17020 as Executrix of this my LAST WILL AND TESTAMENT, and I direct that such person shall serve without bond. IN WITNESS WHEREOF, I have hereunto set my hand and seal at Enola, P~., 17025 this 20th day of October, 1990. Thelma L. Wright Signed, sealed, published and declared to be her LAST WILL AND TESTAMENT BY THE WITHIN NAMED Testator in the presence of us, who in her presence and at her request, and in the presence of each other have hereunto subscribed our names as witnesses: ,' ~ ~ ~? ~, , ~`,~^; ~'~ -- NOTARIAL SFJ\L MARY G SC:HA.N~R, i`Jotary Fublic E. Pennsboro Tvap.. CumbAr'3r~d Co. My Gommis,ion Cxoir~is trc;t. 30, 1990 ~ 1 U ~'~ C~c>~.)~ RENUNCIATION REGISTER OF WILLS COUNTY, PENNSYLVANIA ,,--- Estate of ~~ ~ .~ ~- ~ ~~~ , I, L,r Deceased in my capacity/relationship as /~.- (Print Name) J = !~ ~`' ~' CA ~2~,, of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to 7 - / 7 - ~ ~ ~ z ~ ~ ~~~ -~` ~-- (Date) (Signature) (Street Address) Executed in Register's Office Sworn to or affirmed and subscribed before me this / ~7 clay of -~~~ ~l ~ _ ,-~1~t'j r ~~ ~. Deputy for egister o 'rVills i r3 ~_-_o __ .a ~ ~; ~ -~ ~ .. . , . ..y ~-f ~l T= ~ ~ .... ~~T) ._ _ ---; a --t _ tV 0 ~~~ ~ ; ' ~ ~ ~~~ . / ~ to i a (City, State. Zip) Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciation for the purposes stated within on this day of - Notary Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.) Form RW-06 rev. 10.13.06 REN~~TNCIATION REGISTER OF WILLS Estate of I, COUNTY, PENNSYLVANIA ~, ~ - r-'_~ ~-- ,. ~` • ) ~~ :!i ~ _ ~ ~ , ~ - ~ ~ ~ ~ ~; ~ 0 ,Deceased in my capacity/relationship as (Print Name) / u ~ ~' ~ ~ l"~~ of the above Decedent, hereby renounce the right to administer the Estate of the Decedent and respectfully request that Letters be issued to -~(1_-L -i~ ~o (Date) (signal e) ~~ y c1 ~GC~s ~, ~- Gruen ~~.~ 1 ~~« ; ~ (Street Address) ~T L,~ ve ~~;,-~ ~ ~ . ~~~ / -~G ~li~~ (City, State, Zill) Executed in Register's Office Sworn to or affirmed a~i subscribed before melt is ~ , / ay of ~- U i -" C Deputy fo ~ Regist ~ of Wills Form RW-06 rev. 10.!3.06 Executed out of Register's Office Before the undersigned personally appeared the party executing this renunciation and certified that he or she executed the renunciation for the purposes stated within on this day of , Notary Public My Commission Expires: (Signature and Seal of Notary or other official qualified to administer oaths. Show date of expiration of Notary's Commission.)